Relationship between High Serum Cystatin C Levels and the Risk of Gestational Diabetes Mellitus

Weijing Zhao; Jiemin Pan; Huaping Li; Yajuan Huang; Fang Liu; Minfang Tao; Weiping Jia

doi:10.1371/journal.pone.0147277

Relationship between High Serum Cystatin C Levels and the Risk of Gestational Diabetes Mellitus

PLoS One. 2016 Feb 5;11(2):e0147277. doi: 10.1371/journal.pone.0147277. eCollection 2016.

Authors

Weijing Zhao¹, Jiemin Pan¹, Huaping Li², Yajuan Huang², Fang Liu¹, Minfang Tao², Weiping Jia¹

Affiliations

¹ Shanghai Key Laboratory of Diabetes, Department of Endocrinology & Metabolism, Shanghai Jiao-Tong University Affiliated Sixth People's Hospital, Shanghai Clinical Medical Center of Diabetes, Shanghai Key Clinical Center of Metabolic Diseases, Shanghai Institute for Diabetes, Shanghai, China.
² Department of Obstetrics and Gynecology, Shanghai Jiao-Tong University Affiliated Sixth People's Hospital, Shanghai, China.

Abstract

Aims: Serum cystatin C (CysC) has recently been shown to be associated with the incidence of type 2 diabetes mellitus (T2DM) and progression to the pre-diabetic state. The aim of this study was to explore the relationship between serum CysC and the risk of gestational diabetes mellitus (GDM) in Chinese pregnant women.

Methods: This cross-sectional study consisted of 400 pregnant women including 111 with GDM and 289 with normal glucose tolerance at 24-28 weeks of gestation. The subjects were further divided into four groups according to the CysC quartiles, and their clinical characteristics were compared. The serum CysC concentration was measured using immunoturbidimetry and the degree of insulin resistance was assessed by the homeostasis model assessment of insulin resistance (HOMA-IR).

Results: Serum CysC levels were significantly higher in pregnant women with GDM than in the healthy pregnant women[1.0(0.8-1.8) vs 0.7(0.6-1.0), P<0.01). The Spearman's correlation analysis showed that serum CysC was positively associated with HOMA-IR(r = 0.118, P<0.05) and the occurrence of GDM(r = 0.348, P<0.01). The pregnant women were divided into quartiles according to their serum CysC concentrations. Compared to the first quartile, pregnant women in Q2 (OR, 2.441; P = 0.025), Q3 (OR, 3.383; P = 0.001) and Q4 (OR, 5.516; P<0.001) had higher risk of GDM after adjusted for age, BMI, HbA1c and HOMA-IR. Further, with a rise in the serum CysC, there was an increasing trend in the HOMA-IR levels (P<0.05). A binary logistic regression analysis after adjusting for other confounding variables revealed a significant and independent association between serum CysC and GDM [OR = 14.269; 95% confidence interval, 4.977-40.908, P<0.01].The receiver operating characteristic curve analysis revealed that the optimal cutoff point for serum CysC to indicate GDM was 0.95 mg/L.

Conclusions: Serum CysC is significantly and independently associated with insulin resistance and GDM. It may be a helpful biomarker to identify the risk of GDM in Chinese pregnant women.

Publication types

Research Support, Non-U.S. Gov't

MeSH terms

Adult
Biomarkers
Blood Glucose
Cross-Sectional Studies
Cystatin C / blood*
Diabetes, Gestational / blood*
Diabetes, Gestational / diagnosis*
Diabetes, Gestational / epidemiology
Diabetes, Gestational / etiology
Female
Glucose Tolerance Test
Humans
Insulin / metabolism
Insulin Resistance
Odds Ratio
Pregnancy
Prevalence
ROC Curve
Risk Factors

Substances

Biomarkers
Blood Glucose
Cystatin C
Insulin

Grants and funding

This study was supported by grants from the National Science Foundation of China (81270397 for FL, 81500625 for JP), the Specific Program for Public Welfare supported by the National Health and Family Planning Commission (201502011 for FL and YH) and the Shanghai Science & Technology Pillar Program in the Field of Medicine and Agriculture (15411953100 for FL).